Updates about our Maternity Services and advice for pregnant women
As a pregnant woman the news that you were placed in a ‘vulnerable group’ by the Chief Medical Officer on Monday 16 March 2020 may have caused you concern.
We would like to reiterate that the evidence we have so far is that pregnant women are still no more likely to contract the infection than the general population. What we do know is that pregnancy, in a small proportion of women, can alter how your body handles severe viral infections. This is something that midwives and obstetricians have known for many years and are used to dealing with.
What has driven the decisions made by officials is the need to restrict spread of illness because if the number of infections were to rise sharply, the number of severely infected women could rise and this could put the lives of pregnant women in the third trimester in danger.
Our general advice is that:
- If you are infected with COVID-19 you are still most likely to have no symptoms or a mild illness from which you will make a full recovery.
- If you develop more severe symptoms or your recovery is delayed, this may be a sign that you are developing a more significant chest infection that requires enhanced care. Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team, NHS 111 or local alternative straight away for further information and advice.
Advice regarding social distancing and self-isolation
The UK Chief Medical Officer has decided that, given the limited information currently available about how COVID-19 could affect pregnancy, it would be prudent for pregnant women to increase their social distancing to reduce the risk of infection.
All pregnant women, regardless of gestation, should observe the social distancing guidance available on the Government website. Advice includes the avoidance of contact with people who are known to have COVID-19 or those who exhibit possible symptoms:
- For all vulnerable people including pregnant women: view here
- For individuals and households of individuals with symptoms of new continuous cough or fever: view here
Women above 28 weeks’ gestation should be particularly attentive to social distancing and minimising contact with others. Major new measures have been announced for people at highest risk from Coronavirus. This includes pregnant women with significant heart disease (congenital or acquired).
Advice regarding your appointments or urgent visits to clinics and hospitals at any of our UHDB maternity sites
If you are well at the moment and have had no complications in your previous pregnancies, the following practical advice may be helpful:
- If you have a routine scan or antenatal visit due in the coming days, your Midwifery team will contact you before your appointment is due. You will be asked some screening questions and advised if you still need to attend for a visit. The appointment venue may change and we are now providing some telephone appointments where it is safe to do so and where an antenatal examination is not essential.
- If you are between appointments, please wait to hear from your maternity team. If you are attending more regularly in pregnancy, then your maternity team will be in touch with plans for further appointments, as required.
- There may be a need to reduce the number of antenatal visits you have. This will be communicated with you, and will be done as safely as possible, taking into account available evidence on the safe number of visits required.
- Do not reduce your number of visits without agreeing first with your maternity team.
Whatever your personal situation please consider the following:
Maternity care is essential, and has been developed over many years with improving success to reduce complications in mothers and babies. The risks of not attending care include harm to you, your baby or both of you, even in the context of coronavirus. It is important that you continue to attend your scheduled routine care when you are well.
If you have any concerns regarding your pregnancy but not related to Coronavirus, you should still contact your maternity team at the hospital you are booked at to give birth. The contact number will be the one given to you at booking. Please note the maternity team may need to discuss the need for an appointment with the medical team and this may take longer than usual to get back to you.
If you think you have symptoms of Coronavirus, contact your maternity service and they will arrange the right place and time to come for your visits.
You should not attend a routine clinic if you have any symptoms of Coronavirus or you or a member of your family is self-isolating.
You will be asked to attend your appointment on your own. This will include being asked to not bring children with you to maternity appointments. If your partner has accompanied you to the clinic they will be asked to remain outside the department.
We politely ask that you use the hand sanitizer on arrival and follow social distancing measures by remaining at least 2 meters away from the reception desk and sit in the waiting areas where the chairs have been placed to maintain distance between patients.
At this time, it is particularly important that you help your maternity team take care of you. If you have had an appointment cancelled or delayed, and are not sure of your next contact with your maternity team, please let them know by using the contact numbers provided to you at booking or contacting your community midwife.
Information about our services
Attending for ultrasound scans
You will be asked to attend your appointment on your own. This will include being asked to not bring children with you to maternity appointments. If your partner has accompanied you to the scan they will be asked to remain outside the department.
Attending in labour
Please contact the number of the hospital you are booked at to give birth. You will be asked some screening questions during your telephone call and advised where to attend.
If you have any symptoms of Coronavirus or are self- isolating due to a family member you must inform us before you arrive at the hospital. If you fall into this category you will be asked to put on a mask whilst we transfer you to an isolation room.
Women attending in spontaneous labour can be supported by one birth partner. Good hand hygiene should be used frequently whilst in the unit and entry to and from the ward area must be kept to an absolute minimum.
A birth partner who is symptomatic /unwell or is self–isolating should not attend the unit and must remain at home.
We are currently not recommending the use of the birthing pool for woman with suspected or confirmed Coronavirus.
Use of the birthing pool
We are currently not recommending the use of the birthing pool for woman with suspected or confirmed Coronavirus. Women who are asymptomatic may still use the birthing pool and should be aware that staff will be required to use appropriate PPE.
Induction of labour
Women who require induction of labour will be informed of the date and time to attend the labour ward.
Out-patient induction of labour will be offered where safe to do so. This means that following the start of the induction process and until labour starts, women will be able to return home. Women returning in labour can be supported by one birth partner.
At Royal Derby Hospital induction of labour is undertaken in a 4 bedded induction bay. Birthing partners are able to remain with women during the process providing they are not showing symptoms of coronavirus.
If women require an overnight stay during induction of labour, we would ask birth partners to spend the night at home and return the following day or when labour commences. The reason for this is that we are aiming to support social distancing in the induction bay on labour ward by reducing the number of people spending long periods of time together in close proximity.
At Queen’s Hospital Burton, induction of labour takes place on a maternity ward with Antenatal and post-natal women. In the best interests of all patients on that maternity ward, we ask that the birthing partner attends for the initial admission to the ward and then returns home. When labour starts and women are transferred to the labour ward, their birthing partner can then join them.
Following a straightforward, uncomplicated birth, where safe to do so, we will be asking you to make arrangements to leave the hospital approximately six hours after the birth. If this is not possible or admission to the ward is necessary, we will encourage the parents to spend time together on the labour ward following the birth and politely ask that the birth partner returns home following admission of mother and baby to the postnatal ward.
Caesarean section
Women requiring planned caesarean section will be informed of the date and time to attend the unit. Women attending for a planned caesarean section can be accompanied by their birth partner to the ward and can be present in theatre during the operation. The birth partner will be asked to wear a surgical face mask and adhere to infection prevention and control measures. It is important to understand that all medical and midwifery staff in theatre will be wearing full PPE, we appreciate that this may raise anxiety, however this standard has been agreed locally.
The birth partner will be supported to stay with mother and baby in the recovery area on labour ward prior to transfer to the postnatal ward. Once on the postnatal ward we would ask that the birth partner returns home.
Women who have undergone planned caesarean section without any complication and where baby is fit for home will be supported to consider discharge after 24 hours on the ward if safe to do so.
In cases of emergency caesarean section where immediate delivery of the baby is required (known as category 1 caesarean section), partners will be asked to wait outside theatre during the operation, this is in line with usual practice. The birth partner will be able to accompany their partner post–operatively in the recovery area prior to transfer to the ward.
Women who have undergone emergency caesarean section may require hospital stay greater than 24 hours.
Homebirths
The homebirth services across UHDB remain suspended and the birthing facility at Samuel Johnson Maternity Unit, Lichfield, remains closed.
Postnatal care
Babies will not be separated from their mothers unless there is a clear clinical need.
Breast feeding is still encouraged.
There is no visiting on the postnatal ward due to following strict social distancing recommendations for all pregnant women, the aim of which is to reduce the risk of infection to unwell mothers and babies who require medical admission.
Postnatal care following discharge home will still be provided by the community Midwifery teams. Visits will be assessed on and individual basis and women will be contacted by the community midwife before they arrange a home visit. We politely ask that when the midwife attends she sees the mother and baby alone in a separate room away from other family members where possible.
General information
The maternity team acknowledges that this is a challenging time for expectant mothers and new parents. Information and guidance is regularly changing and we will make every effort to keep women and families updated. Our priority is to provide safe maternity care and to support a positive birth experience for all during this time of change and service reconfiguration.
Despite these changes we will still support you with the many choices available, positions for labour, aromatherapy, relaxation support using music during labour, pain relief options, mobilisation, infant feeding support etc. Please talk to your maternity teams if you require further information.
Contact details
See our Maternity Wards contact details here.
See our Birth centre contact details here.
See our Labour ward contact details here.
View our Maternity pages on our website here.